• The most common cause of postpartum hypertension is high blood pressure (from gestational hypertension or pre-eclampsia) that persists after delivery
• Suggested first line antihypertensive drugs that are safe in breastfeeding mothers include labetalol, nifedipine, and enalapril
• Refer women with persistent hypertension or proteinuria six weeks after delivery to a specialist
• Inform women with recent hypertensive disorders of pregnancy of the risk of recurrence in a future pregnancy
• Women with pre-eclampsia have a 3.7-fold increased risk of future hypertension, 2.2-fold risk of ischaemic heart disease, and 1.8-fold risk of stroke

Hypertension in the postpartum period affects several groups of women, including those with previous chronic hypertension, gestational hypertension, pre-eclampsia, and eclampsia. In addition, pre-eclampsia may present for the first time in the postnatal period. Although the underlying causes and clinical presentation of these types of hypertension vary, patients can be investigated and treated in a similar manner. This review covers management of postpartum hypertension and its future consequences. Hypertension affects 6-10% of pregnancies,1 but few studies have reported the incidence of postpartum hypertension. This review is relevant to general practitioners, obstetricians, and specialists in secondary care who may see women with postpartum hypertension.

Source:BMJ